Background: The Renal Registry of Bosnia and Herzegovina systematically collects national data on kidney replacement therapy for patients with end-stage kidney disease (ESKD). This report summarizes 2 decades of registry data (2002-2022), showing trends in incidence, prevalence, modality distribution, and patient outcomes. Methods: Data were obtained annually from 30 dialysis centers across the country. Incidence, prevalence, and survival rates for hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation were calculated per million population (pmp). Descriptive statistics and Kaplan–Meier survival analyses were performed using SPSS 25. Results: Between 2002 and 2022, the number of dialysis centers increased from 18 to 30, and the total treated population rose by 43.5% (from 1687 to 2421 patients). Hemodialysis remained the predominant modality (80.4%), while PD accounted for only 3.0% of all dialysis patients. The incidence rate in 2022 was 118.9 pmp, and the prevalence reached 685.6 pmp. The leading causes of ESKD were diabetic nephropathy (29.5%) and hypertensive nephropathy (13.1%). The crude mortality rate among dialysis patients in 2022 was 13.2%, primarily due to cardiovascular disease. By the end of 2022, a total of 402 patients lived with a functioning kidney graft. Conclusion: Over the past 2 decades, Bosnia and Herzegovina has experienced steady growth in its dialysis population and gradual improvements in registry coverage. However, the country continues to face challenges, including low utilization of PD and limited transplantation activity. Strengthening early chronic kidney disease detection and expanding organ donation programs remain key national priorities.   Cite this article as: Resić H, Rebić D, Turković AM. The renal registry of Bosnia and Herzegovina. Turk J Nephrol. Published online May 11, 2026. doi: 10.10.5152/turkjnephrol.2026.25988.

There is no medical field where the impact of medical evolution is more palpable than in kidney transplantation. The pioneers of this procedure, 70 years ago, laid out the foundation for organ transplantation in general and kidney transplantation in particular. Despite the incredible advancements that have been made since, huge differences exist worldwide in terms of access, equity and quality of care. Nowhere are these disparities more prominent than in developing countries with limited resources, underfunded healthcare systems and transplantation infrastructures, particularly the Western Balkans. This position paper delineates the biggest barriers hindering the development of kidney transplantation in the Western Balkans, put forth and agreed upon by a group of regional experts on the field, based on the Modified Delphi Method. Limitations in training, infrastructure, restrictive and outdated legislative practices, lack of a centralized coordination network and fragmented regional collaboration, emerged as the principal challenges. Endorsed by European Society for Organ Transplantation (ESOT), this paper outlines a pragmatic and practical framework to overcome these obstacles, towards building robust and sustainable transplantation programs that ensure high-quality and equitable access to kidney transplantation, for all patients in this region.

Objective. We describe a rare case of satisfactory renal allograft function without immunosuppressive therapy following allogeneic hematopoietic stem cell transplantation (alloHSCT). Case Report. The patient was a 64-year-old male who had undergone a kidney transplant from a sibling donor in 2007. After 16 years, he required alloHSCT for acute myeloid leukemia (AML), with the same sibling serving as the donor for both transplants. HLA was a 50% match. Post-alloHSCT, immunosuppressive therapy was discontinued, and the renal allograft function remained stable. The patient later developed severe complications and succumbed to infection. Insights into the precise tolerance mechanisms were limited because laboratory evaluation for chimerism was not performed. Conclusion. There is potential for immunosuppressive-free renal allograft function after alloHSCT. This case underscores the significant risk of infection-related mortality. To achieve the best outcome, rigorous patient selection, tailored conditioning regimens, robust infection prevention strategies, and the possibility of combined transplantation for carefully selected patients are needed.

elevated nocturnal BP clinic BP monitoring alone is inadequate. ABPM should become golden standard to confirm adequate BP control in patients with kidney disease.

INTRODUCTION Peritoneal dialysis and hemodialysis are complementary ways of treating end-stage renal failure. Changing the dialysis modality from hemodialysis to peritoneal dialysis is a rare and poorly studied phenomenon. MATERIALS AND METHODS Retrospective cohort study conducted on the population of adult patients with end-stage chronic renal failure who were treated at the Nephrology Clinic of the Clinical Center of the University of Sarajevo in the period from 2006 to 2023. A total of 109 adult patients, whose medical documentation was complete and who were in the peritoneal dialysis program at the Nephrology Clinic of the Clinical Center of the University of Sarajevo during the observed period, were included in this study. One group started the treatment with peritoneal dialysis, and the other with hemodialysis. Demographic data were collected for each patient: age, gender, underlying kidney disease, comorbidities (heart disease and diabetes), duration of treatment modality, data on modality change, complications and treatment outcomes. Data from physical and electronic patient histories were used. RESULTS Total of 109 adult patients were included in this study. They are divided into two groups. Group 1 (n=99) in which peritoneal dialysis was the first treatment modality and Group 2 (n=10) in which haemodialysis was the first treatment modality, but in which patients, after a certain time, were transferred to peritoneal dialysis. The median age of patients in Group 1 was 60 (-/-14.07) years and 54 (-/+12.23) years for Group 2. Within Group 1 the most common cause of terminal renal failure was diabetic nephropathy (n=40, 40.4%) and nephroangiosclerosis (n=24, 24.24%). The mean age of onset of peritoneal dialysis was 60 (-/-14.07) years, while the mean age of cessation of peritoneal dialysis was 63 (±13.69) years. The average duration of peritoneal dialysis treatment was 38.36(±34.14) months. During the stay at peritoneal dialysis, death was recorded in 63 patients (62.38%). The number of patients who replaced peritoneal dialysis treatment with hemodialysis was 26. The most common reason for switching to haemodialysis was insufficiency of peritoneal dialysis (n=13, 14%). After switching to haemodialysis, the average length of staying on it was 10.22 months. The reason for discontinuation of haemodialysis was death (n=17, ) or transplantation (n=1, 3.7%). Kaplan-Meier test shown worse outcome in patients with haemodialyis first than peritoneal dialysis first. CONCLUSION Changing the dialysis modality carries with it a high risk of mortality, especially in the first month. Changing the way of active treatment with dialysis speaks in favor of severe comorbidities.

Abstract Background/aim: Diabetes mellitus is a metabolic disorder of multiple etiologies characterized by a lack of insulin, with a consequent disordered metabolism of glucose, fats, and proteins. A number of complications, such as diabetic nephropathy and retinopathy, may develop as a result of long-term diabetes. The aim of this study aimed to determine the correlation between diabetic nephropathy and diabetic retinopathy as long-term complications of diabetes mellitus. Materials and methods: Retrospective, descriptive, and analytical research was conducted at the department of Endocrinology, Clinical Center, University of Sarajevo. The study included 158 patients hospitalized in time between 1st of January and 31st of December 2012. Results: New-onset diabetes was found in 38%, and diabetes type 2 patients 132 (83.5%), female 105 (66.5%) while older than 60 years were 100 (63.3%). Upon discharge from hospital 83,7% of patients were discharged with glycemia <10 mmol / l. We found that 47,5% of patients had HbA1c> 10%. Reduced kidney function, different degrees of failure was at 66.5%. More than half (62.7%) patients had proteinuria as a sign of diabetic nephropathy. Diabetic retinopathy was diagnosed with different types in 54.4%. Conclusion: Diabetes leads to an increase in nitrogen compounds, and the development of diabetic nephropathy manifests as various degrees of renal insufficiency. The duration of diabetes and occurrence of diabetic retinopathy were significantly interrelated. The correlation between the degree of renal failure and changes in the ocular fundus has not been proven, but more severe renal insufficiency is associated with a higher incidence of diabetic retinopathy compared to patients with less impaired renal function.